Farm Loan Programs - Direct Loan Making

Instructions For FSA-2001

REQUEST FOR DIRECT LOAN ASSISTANCE

This form is used to obtain information from applicants applying for FSA farm loan assistance.

Submit the original of the completed form in hard copy or facsimile to the appropriate USDA servicing office.

Producers must complete all applicable fields in Parts A through J on the form, including a valid signature and date.

PART A – Primary Applicant / Farm Operator

Items 1 – 6 are completed by the primary applicant (the individual/entity who is or will be the operator of the farm).

Fld Name / Item No.	Instruction
1 Exact Full Legal Name	Enter your full legal name as it appears on your driver's license or State-issued ID card. (Example: John Wayne Doe) If applying as an entity, enter the full legal name of the ENTITY as shown on Articles of Incorporation, partnership agreement, as filed with the Secretary of State, etc. (Example: John W. Doe Farms, LLC)
2A Address Line 1	Enter your street address.
2B Address Line 2	Enter your mailing address/P.O. Box, if applicable.
2C City	Enter the corresponding city.
2D State	Enter the corresponding state.
2E Zip	Enter the corresponding zip code.
3A Primary Phone Number	Enter your home or cellular telephone number and select appropriate box.
3B Alternative Phone Number	If applicable, enter an additional number where you can be reached and select appropriate box.
4 Email Address	Enter your email address.
5 Applicant Type	Select applicant type from the table and complete the listed parts of the application as applicable to the applicant type selected.
6 Existing Customer	If you are an existing customer and your information hasn't changed check the box and skip Parts B, C and D. If you are NOT an existing customer, leave this box unchecked and proceed to Part B or C as instructed from the table in Item 5.

PART B – Primary Applicant Information

Items 1 – 9 are completed by the primary applicant (the individual who is the operator of the farm and previously identified in Part A). If you are applying as a Legal Entity, SKIP this part PROCEED to Part C.

Fld Name / Item No.	Instruction
1 Social Security Number (9 Digits)	Enter your 9-digit social security number (without dashes).
2 Birth Date (MM/DD/YYYY)	Enter your date of birth in the format MM/DD/YYYY.
3 County of Operation Headquarters	Enter the county where the operation headquarters is located.
4 Military Veteran Status	Select your veteran status. Note: A veteran is anyone who has served in the U.S. armed services. A veteran farmer without military experience does not qualify as a veteran.
5 Marital Status	Select your marital status.
6 Applicant Is	Select your citizenship status Note: If you are a non-citizen national, qualified alien, or refugee, you must provide documentation of your immigration status.
7 Ethnicity	Select your ethnicity. Note: Providing your ethnicity is voluntary unless you are applying as a socially disadvantaged applicant.
8 Race	Select your race. More than one checkbox may be selected. Note: Providing your race is voluntary unless you are applying as a socially disadvantaged applicant.
9 Gender	Select your gender. Note: Providing your gender is voluntary unless you are applying as a socially disadvantaged applicant.

PART C – Entity Applicant Information

Items 1 – 9 are completed by the entity applicant. If you are not applying as a LEGAL ENTITY, SKIP this Part.

Fld Name / Item No.	Instruction
1 Entity Type	Select your Entity Type. If your entity type is not listed, select “Other” and enter the entity type in the space provided.
2 State of Registration	Enter the State where the entity is registered or incorporated.
3 Registration Number	Enter the entity’s registration number.
4 Tax Identification Number (9 Digits)	Enter the entity’s 9-digit tax identification number.
5 Exact Full Legal Name of Primary Entity Contact	Enter the exact full legal name of the primary entity contact.
6 Does Entity Contain An Embedded Entity?	If the Operating Entity has one or more embedded entities within its composition, check “YES” and complete items 7 – 9. Otherwise, check “NO” and proceed to Part D.
7 List All Embedded Entities	If you answered “YES” in Item 6, enter the names of all embedded entities within the Operating Entity.
8 Percentage of Interest	If you answered “YES” in Item 6, enter the percentage of interest that each embedded entity holds in the Operating Entity.
9 Number of Entity Members	If you answered “YES” in Item 6, enter the number of individual members within each embedded entity holding an interest in the Operating Entity.

PART D – Other Member Information

Items 1 – 15 are completed by each entity applicant (or spouse(s) if applying jointly). This page allows space for 2 members to provide their information. If there are more than 2 members, please DUPLICATE this page as needed to include ALL entity members.

If you are NOT applying as a either an Informal or Legal Entity, SKIP this Part and PROCEED to Part E.

Fld Name / Item No.	Instruction
1 Exact Full Legal Name of Entity Member	Enter the entity member’s full legal name as it appears on their driver's license or State-issued ID card.
2 Social Security Number (9 Digits)	Enter your 9-digit social security number (without dashes).
3 Birth Date (MM-DD-YYYY)	Enter your date of birth in the format MM/DD/YYYY.
4A Street Address	Enter your street address. If this differs from your mailing address, please enter both addresses.
4B City	Enter the corresponding city.
4C State	Enter the corresponding state.
4D Zip	Enter the corresponding zip code.
5 Phone Number	Enter your preferred contact telephone number.
6 Percentage of Ownership	Enter applicant's percentage of ownership interest in the Operating Entity or embedded entity.
7 Email Address	Enter applicant's email address.
8 Occupation/Employment	Enter the principal occupation of the entity member.
9 Annual Non-Farm Income	Enter the annual (yearly) non-farm income of the entity member. This figure should be the gross income (i.e. - before taxes).
10 Military Veteran Status	Select your veteran status. Note: A veteran is anyone who has served in the U.S. armed services. A veteran farmer without military experience does not qualify as a veteran.
11 Marital Status	Select your marital status.
12 Applicant Is	Select your citizenship status Note: If you are a non-citizen national, qualified alien, or refugee, you must provide documentation of your immigration status.
13 Ethnicity	Select your ethnicity. Note: Providing your ethnicity is voluntary unless you are applying as a socially disadvantaged applicant.
14 Race	Select your race. More than one checkbox may be selected. Note: Providing your race is voluntary unless you are applying as a socially disadvantaged applicant.
15 Gender	Select your gender. Note: Providing your gender is voluntary unless you are applying as a socially disadvantaged applicant.

PART E – Loan Request

Items 1 – 3 are completed by the ALL applicant types. This application allows for the submission of up to 3 different loan requests on a single application form.

Fld Name / Item No.	Instruction
1 Type of Request	Select the type of request that you are making. For a NEW LOAN(s), select “New Loan Request”. For existing applicants requesting loan servicing, select “Loan Servicing Request”. For applicants applying under the Transfer & Assumption process, select “Transfer & Assumption”.
1A Request 1 of ___	Enter the total number of loan requests the applicant is requesting. (e.g. – If applying for only 1 loan, enter 1. If applying for 2 loans, enter 2, etc.)
1B Use of Loan Proceeds	Enter a description of the use of loan proceeds. Similar loan requests can be combined into one request. Authorized uses include: FARM OWNERSHIP LOANS (FO)* FO - Purchase a farm FO - Enlarge or improve an existing farm FO - Construct new farm buildings FO - Improve existing farm buildings FO - Pay closing costs FO - Implement soil and water conservation and protection practices. *FO loans have a borrower loan limit# of $600,000. Beginning Farmer Down Payment loans have a maximum loan amount of $300,150. OPERATING LOANS (OL)** ANNUAL OPERATING LOANS (A-OL) A-OL - Annual input costs and Family living expenses A-OL - Purchase market livestock TERM OPERATING LOANS (T-OL) T-OL - Initial start-up expenses T-OL - Purchase of equipment T-OL - Purchase breeding livestock T-OL - Purchase materials essential to farm operations T-OL - Minor farm improvements T-OL - Hoop houses T-OL - Essential tools T-OL - Irrigation T-OL - Farm vehicles **Operating loans have a borrower loan limit# of $400,000 EMERGENCY LOANS (EM) – Borrower loan limit# of $500,000 CONSERVATION LOANS PROGRAM (CL) – Borrower loan limit# included with Farm Ownership Loan limits # Borrower loan limit – The outstanding principal balance for a farm loan applicant, or anyone who will sign the promissory note, cannot exceed this limit at loan closing.
1C Amount Requested	Enter the loan amount requested for this loan request.
2A Request 2 of ___	If more than one loan is being requested, enter the total number of loan requests the applicant is requesting. (e.g. – If applying for only 1 loan, LEAVE BLANK. If applying for 2 loans, enter 2. If applying for 3 loans, enter 3, etc.)
2B Use of Loan Proceeds	Enter a description of the use of loan proceeds. Similar loan requests can be combined into one request. Authorized uses include: FARM OWNERSHIP LOANS (FO)* FO - Purchase a farm FO - Enlarge or improve an existing farm FO - Construct new farm buildings FO - Improve existing farm buildings FO - Pay closing costs FO - Implement soil and water conservation and protection practices. *FO loans have a borrower loan limit# of $600,000. Beginning Farmer Down Payment loans have a maximum loan amount of $300,150. OPERATING LOANS (OL)** ANNUAL OPERATING LOANS (A-OL) A-OL - Annual input costs and Family living expenses A-OL - Purchase market livestock TERM OPERATING LOANS (T-OL) T-OL - Initial start-up expenses T-OL - Purchase of equipment T-OL - Purchase breeding livestock T-OL - Purchase materials essential to farm operations T-OL - Minor farm improvements T-OL - Hoop houses T-OL - Essential tools T-OL - Irrigation T-OL - Farm vehicles **Operating loans have a borrower loan limit# of $400,000 EMERGENCY LOANS (EM) – Borrower loan limit# of $500,000 CONSERVATION LOANS PROGRAM (CL) – Borrower loan limit# included with Farm Ownership Loan limits # Borrower loan limit – The outstanding principal balance for a farm loan applicant, or anyone who will sign the promissory note, cannot exceed this limit at loan closing.
2C Amount Requested	Enter the loan amount requested for this loan request.
3A Request 3 of ___	If more than one loan is being requested, enter the total number of loan requests the applicant is requesting. (e.g. – If applying for only 1 or 2 loans, LEAVE BLANK. If applying for 3 loans, enter 3. If additional request space is needed, page will need to be duplicated.)
3B Use of Loan Proceeds	Enter a description of the use of loan proceeds. Similar loan requests can be combined into one request. Authorized uses include: FARM OWNERSHIP LOANS (FO)* FO - Purchase a farm FO - Enlarge or improve an existing farm FO - Construct new farm buildings FO - Improve existing farm buildings FO - Pay closing costs FO - Implement soil and water conservation and protection practices. *FO loans have a borrower loan limit# of $600,000. Beginning Farmer Down Payment loans have a maximum loan amount of $300,150. OPERATING LOANS (OL)** ANNUAL OPERATING LOANS (A-OL) A-OL - Annual input costs and Family living expenses A-OL - Purchase market livestock TERM OPERATING LOANS (T-OL) T-OL - Initial start-up expenses T-OL - Purchase of equipment T-OL - Purchase breeding livestock T-OL - Purchase materials essential to farm operations T-OL - Minor farm improvements T-OL - Hoop houses T-OL - Essential tools T-OL - Irrigation T-OL - Farm vehicles **Operating loans have a borrower loan limit# of $400,000 EMERGENCY LOANS (EM) – Borrower loan limit# of $500,000 CONSERVATION LOANS PROGRAM (CL) – Borrower loan limit# included with Farm Ownership Loan limits # Borrower loan limit – The outstanding principal balance for a farm loan applicant, or anyone who will sign the promissory note, cannot exceed this limit at loan closing.
3C Amount Requested	Enter the loan amount requested for this loan request.

PART F – Training, Education, and Experience

Items 1 & 2 are completed by ALL applicant types.

Fld Name / Item No.	Instruction
1 Training, Education, and/or Experience	Mark all training, education, and experience that apply to an applicant, members of an entity applicant, or co-applicant(s).
2 Explanation	Enter additional information on the training, education and/or experience selected in item 1 and/or other items that are not listed above.

PART G – Certification & Eligiblity

Items 1 – 8 are applicable to ALL applicants.

Fld Name / Item No.	Instruction
1 Business Under Other Name(s)	Select “YES” if you (or any member of the entity) have ever conducted business under another name. If “YES” provide names used in item 8; otherwise check "NO"
2 Previous FSA or FmHA loans	Select “YES” if you (or any member of the entity) have ever obtained a direct or guaranteed farm loan from FSA or the Farmers Home Administration; if not check “NO”.
3 Debt Forgiveness	Select “YES” if the government ever forgave any previous debt through a write-down, write-off, compromise, adjustment, reduction, charge-off, paying a loss on a guarantee, or bankruptcy. If “YES”, provide details in Item 8; otherwise check “NO”.
4 Delinquent on Federal Debt	Select “YES” if you (or any member of the entity) are delinquent on any federal debt. Federal Debt includes education loans, delinquent taxes, obligations at Natural Resources Conservation Service, obligations to FCIC, etc. If “YES,” provide details in Item 8; otherwise check “NO”.
5 Pending Litigation	Select “YES” if you (any member of the entity, or the entity itself) are involved in any pending litigation. If “YES,” provide details in Item 8; otherwise check “NO”.
6 Bankruptcy	Select “YES” if you (or any member of the entity) have filed a petition for bankruptcy. If “YES,” provide details in Item 8; otherwise check “NO”.
7 Employee Relationship	Select “YES” if you are an employee, related to an employee, or closely associated with an employee of the Farm Service Agency. If “YES” provide details in Item 8; otherwise check “NO”.
8 Additional Answers	Provide explanations to any “YES” responses for Items 1–7.

PART H – Balance Sheet

Note: This part of the form may be substituted. Applicants may submit alternative documents (which are less than 90 days old) that provide the information collected on this part. CHECK THE BOX in the header at the top of this part if you are submitting an alternative document in lieu of this Part. Applicants using this option will then proceed to Part I.

All other applicants will need to complete this Part in its entirety for all applicable items.

Fld Name / Item No.	Instruction
Balance Sheet of	Enter the name of the person or entity completing this balance sheet. If you are an entity applicant, you must DUPLICATE this Part and provide a Balance Sheet for the entity itself, as well as ALL entity members. If married couples are completing this part jointly, BOTH the applicant AND the spouse’s name must be listed in this field.
As of	Enter the date you are completing this balance sheet in the format MM/DD/YYYY.
1A	CURRENT FARM ASSETS
1A Cash & Equivalents (Sch. A)	Enter the total value of cash and equivalents (total of all items in 4A on page 5).
1A Marketable Bonds & Securities	Enter the dollar value of short-term investments that will be maturing in less than 12 months (for example, certificates of deposit, treasury bills, hedging account equity, etc.).
1A Accounts Receivable (Sch. B)	Enter the total value of all accounts receivable (total of all items in 4B on page 5).
1A Crop Inventory (Sch. C)	Enter the total value of all crop inventory (total of all items in 4C on page 5).
1A Growing Crops (Sch. D)	Enter the total value of all growing crops (total of all items in 4D on page 5).
1A Market Livestock & Poultry (Sch. E)	Enter the total value of all market livestock & poultry (total of all items in 4E on page 5).
1A Livestock Products (Sch. F)	Enter the total value of all livestock products (total of all items in 4F on page 5).
1A Prepaid Expenses & Supplies (Sch. G)	Enter the total value of prepaid expenses and supplies (total of all items in 4G on page 5).
1A Other Current Assets	Enter the description and value of any other current asset that has not been accounted for on this form. Other current assets include: trade receivables, cash surrender of life insurance, advances paid to employees or suppliers, etc.
1A Total Current Farm Assets	Enter the total value of all current farm assets listed in 1A on page 4.
1B	CURRENT FARM LIABILITIES
1B Accounts Payable (Sch. AA)	Enter the total PRINCIPAL BALANCE of all accounts payable (total of all items in 5A - Sch. AA on page 6)
1B Income Taxes Payable	Enter the total income taxes owed as of the date of this balance sheet. This includes State, Federal Income, and Social Security taxes.
1B Real Estate Taxes Payable	Enter any taxes owed on real estate and/or personal property as of the date of this balance sheet.
1B Notes Payable (12 months or less) (Sch. BB)	Enter the total PRINCIPAL BALANCE of all Farm Notes Payable - 12 months or less (total of all items in 5B - Sch. BB on page 6)
1B Total Annual Payments of Int. Notes Payable (Sch. CC)	Enter the total PAYMENTS of all Farm Intermediate Debts Payable - between 1-7 years (total of all items in 5C - Sch. CC on page 6)
1B Total Annual Payments of L. Term Notes Payable (Sch. DD)	Enter the total PAYMENTS of all Farm Long Term Debts Payable - over 7 years (total of all items in 5D - Sch. DD on page 6)
1B Total Current Farm Liabilities	Enter the total value of all current farm liabilities listed in item 1B on page 4.
1C	INTERMEDIATE FARM ASSETS
1C Machinery & Equipment (Sch. H)	Enter the total value of machinery and equipment (total of all items in 4H - Sch. H on page 5).
1C Farm Vehicles (Sch. I)	Enter the total value of farm vehicles (total of all items in 4I - Sch. I on page 5).
1C Breeding Stock (Sch. J)	Enter the total value of breeding stock (total of all items in 4J - Sch. J on page 5).
1C Notes Receivable (Sch. K)	Enter the total value of notes receivable (total of all items in 4K - Sch. K on page 5).
1C Not Readily Marketable Bonds & Securities	Enter other investments and the value of each. Examples include certificates of deposit, treasury bills, etc.
1C Other Intermediate Assets	Enter other intermediate assets and the value of each. Other assets include co-op stock, life insurance cash value, etc.
1C Total Intermediate Farm Assets	Enter the total value of all intermediate farm assets in 1C.
1D	INTERMEDIATE FARM LIABILITIES
1D Debts due in over 1 year but less than 7 (Sch. CC)	Enter the total PRINCIPAL BALANCE of all Intermediate Farm Liabilities (total of all items in 5C - Sch. CC on page 6).
1D Total Intermediate Farm Liabilities	Enter the total value of all intermediate farm liabilities listed in item 1D on page 4.
1E	LONG-TERM FARM ASSETS
1E Buildings & Improvements (Sch. L)	Enter the total value of all buildings and improvements (total of all items in 4L - Sch. L on page 5).
1E Real Estate – Land (Sch. M)	Enter the total value of all real estate - land (total of all items in 4M - Sch. M on page 5).
1E Other Long-term Assets	Enter any other long-term assets not previously listed on the balance sheet and the value of each.
1E Total Long-term Assets	Enter the total value of all long-term farm assets in 1E.
1F	LONG-TERM FARM LIABILITES
1F Debts due over 7 years (Sch. DD)	Enter the total PRINCIPAL BALANCE of all Long-Term Farm Liabilities (total of all items in 5D - Sch. DD on page 6).
1F Total Long-Term Liabilities	Enter the total value of all long-term farm liabilities listed in item 1F on page 4.
2A	CURRENT PERSONAL ASSETS
2A Cash & Equivalents (Sch. N)	Enter the total value of cash and equivalents (total of all items in 4N - Sch. N on page 5).
2A Marketable Bonds & Securities	Enter the dollar value of short-term investments that will be maturing in less than 12 months (for example, certificates of deposit, treasury bills, hedging account equity, etc.).
2A Cash Value Life Insurance (NOT Face Value)	Enter the cash value of life insurance policies, if applicable.
2A Other Current Assets	Enter the type and value of any other personal current assets.
2A Total Current Personal Assets	Enter the total of all current personal assets listed in 2A on page 4.
2B	CURRENT PERSONAL LIABILITIES
2B Notes Payable (12 months or less) (Sch. EE)	Enter the total PRINCIPAL BALANCE of all personal notes payable (total of all items in 6A - Sch. EE on page 6)
2B Credit Card Debt (Sch. FF)	Enter the total BALANCE of all credit cards (total of all items in 6B - Sch. FF on page 6)
2B Total Current Personal Liabilities	Enter the total of all current personal liabilities listed in 2B on page 4.
2C	INTERMEDIATE PERSONAL ASSETS
2C Household Goods	Enter the approximate value of all household goods (contents of your personal residence).
2C Car, Recreational Vehicles, etc. (Sch. O)	Enter the total value of car, recreational vehicles, etc. (total of all items in 4O - Sch. O on page 5)
2C Other Intermediate Assets	Enter the type and value of any other personal intermediate assets.
2C Total Intermediate Personal Assets	Enter the total of all intermediate personal assets listed in 2C on page 4.
2D	INTERMEDIATE PERSONAL LIABILITIES
	This section is intentionally left blank. Proceed to Section 2E.
2E	LONG-TERM PERSONAL ASSETS
2E Retirement Accounts (Sch. P)	Enter the total value of retirement accounts (total of all items in 4P - Sch. P on page 5)
2E Non-Farm Business	Enter the value of all non-farm businesses.
2E Non-Farm Real Estate (Sch. Q)	Enter the total value of non-farm real estate (total of all items in 4Q - Sch. Q on page 5)
2E Other Long-Term Assets	Enter the type and value of any other personal long-term assets.
2E Total Long-Term Personal Assets	Enter the total of all long-term personal assets listed in 2E on page 4.
2F	LONG-TERM PERSONAL LIABILITIES
2F Debts due over 1 year (Sch. GG)	Enter the total PRINCIPAL BALANCE of all personal term debts payable (total of all items in 6C - Sch. GG on page 6)
2F Total Long-Term Personal Liabilities	Enter the total of all long-term personal liabilities listed in 2F on page 4.
3	TOTALS & NET
3A Grand Total Assets	Enter the total of all assets (Total of Items in 1A, 1C, 1E, 2A, 2C & 2E on page 4).
3B Grand Total Liabilities	Enter the total of all liabilities (Total of Items in 1B, 1D, 1F, 2B & 2F on page 4).
3C Total Net Equity	Grand Total Assets less/minus Grand Total Liabilities is the formula for Net Equity. Subtract the amount in 3B from the amount and 3A and enter the result here. (Item 3A – Item 3B = Item 3C)
4A-4M	ASSET SCHEDULES - FARM
4A Cash on Hand	Enter the dollar value of farm cash on hand (dollar bills/currency).
4A Checking	Enter the dollar value of your farm checking account.
4A Savings	Enter the dollar value of your farm savings account.
4B Description	Enter the account names of money due to be paid within the next 12 months to the applicant for goods or services delivered.
4B Market Value	Enter the amount of money due for each account listed to be paid within the next 12 months to the applicant for goods or services delivered.
4C Type	In each row, enter the types of crops and feed on hand (in inventory) on the farm or in commercial storage.
4C Measure	For each row of crops entered in Type, enter the unit of measure (weight, bushels, tons, etc.) for that crop type.
4C # Units	For each row of crops entered in Type, enter the number of units held in storage.
4C $/Unit	For each row of crops entered in Type, enter the price per unit of measure. Note: Prices should reflect market values for the date of the balance sheet.
4C Market Value	For each row entered in Schedule C - Crop Inventory, enter the total crop value. Note: Calculate the total value by multiplying the number of units by the price per unit.
4D Type	In each row, enter each type of crop that is presently growing in the field as of the date of this balance sheet.
4D # Acres	For each row of crops entered in Type, enter the total number of acres per crop. Note: If you are growing less than an acre, you can respond using a fraction of an acre.
4D Cost/Acre	For each row of crops entered in Type, enter the estimated cost per acre for inputs, such as seed, fertilizer, fuel, etc.
4D Market Value	For each row of crops entered in Type, enter the total value of each crop. Note: Calculate the total value of each crop by multiplying the number of acres by the cost per acre.
4E Type	In each row, enter the types of livestock or poultry that will be sold within 12 months.
4E # Head	For each row of livestock or poultry (entered in Type), enter the number of livestock/poultry to be sold.
4E Weight	For each row of livestock or poultry (entered in Type), enter the average weight (per unit head) for each type of livestock/poultry to be sold. If pricing per head is preferred, a “1” must be entered in this column for the total to calculate correctly.
4E $/Unit	For each row of livestock or poultry (entered in Type), enter the market price per unit as of the date of this balance sheet.
4E Market Value	For each row of livestock or poultry (entered in Type), enter the total value of each type of livestock to be sold. Note: Calculate the total value of each type of livestock to be sold by multiplying the number of livestock/poultry by the weight by the market price per unit.
4F Type	In each row, enter the type of livestock products that will be sold within 12 months (for example, meat, eggs, fur, leather, wool, etc.).
4F Measure	For each row of livestock products (entered in Type), enter the unit of measure for that product type.
4F # Units	For each row of livestock products (entered in Type), enter the number of units held in inventory.
4F $/Unit	For each row of livestock products (entered in Type), enter the price per unit for each product as of the date of this balance sheet.
4F Market Value	For each row of livestock products (entered in Type), enter the total value for each type of livestock product. Note: Calculate the total value for each type of livestock product by multiplying the number of units by the price per unit.
4G Description	In these rows, specify supplies on hand and/or prepaid expenses. Examples of supplies on hand include fertilizers, seeds, chemicals, fuel, etc. Note: The value of prepaid expenses should reflect the actual costs.
4G Market Value	Enter the total value of each supply and/or prepaid expenses.
4H Type	Enter a description of the type of equipment (for example, tractor, plow, etc.).
4H Make	Enter the manufacturer of the equipment listed in Type.
4H Model	Enter model (size and type) of equipment listed in Type.
4H Year	Enter the year of manufacture (or an approximation, if unknown).
4H Market Value	Enter the estimated market value (as of the date of this balance sheet).
4I Equip. Type	Enter a description of the type of farm vehicle (for example, green truck, red side by side, etc.).
4I Make	Enter the manufacturer of the farm vehicle listed in Type.
4I Model	Enter the model (size/type) of the farm vehicle.
4I Year	Enter the year of manufacture (or an approximation, if unknown).
4I Market Value	Enter the estimated market value as of the date of this balance sheet.
4J Type	In each row, specify each type of breeding stock owned.
4J Raised/Purch	For each type of breeding stock specified in Type, enter R if you raised the livestock or P if they were purchased.
4J # Units	For each type of breeding stock specified in Type, enter the animal headcount.
4J $/Unit	For each type of breeding stock specified in Type, enter the current market price per animal for each type (as of the date of this balance sheet).
4J Market Value	For each type of breeding stock specified in Type, enter the value. Note: Calculate the value by multiplying the number of heads by the price per head.
4K Description	Enter accounts and money owed to the applicant that will not be received in the current year but will be received within 10 years.
4K Market Value	Enter the dollar amount for each account owed to the applicant that will not be received in the current year but will be received within 10 years.
4L Description	List all buildings and improvements owned.
4L Market Value	List the value of all buildings and improvements owned (as of the date of this balance sheet).
4M Farm Name	Provide a brief description or farm name of each real estate parcel owned in each row. (Farm name could include legal description such as section/township/range).
4M Total Acres	Enter total acres for the parcels listed under farm name.
4M % Owned	Enter the percent of ownership the applicant holds for land listed under farm name.
4M $/Acre	Enter the market value per acre for the land listed in farm name.
4M Market Value	Enter the total value of the land by multiplying the number of acres by the percentage of ownership by the value per acre.
4N-4Q	ASSET SCHEDULES – PERSONAL
4N Cash On Hand	Enter the dollar value of personal cash on hand (dollar bills/currency).
4N Checking	Enter the dollar value of your personal checking account.
4N Savings	Enter the dollar value of your personal savings account.
4O Type	Enter the type of all personal, recreational, or non-farm vehicles.
4O Make	Enter the manufacturer of the personal vehicle listed in Type.
4O Model	Enter the model (size/type) of the personal vehicle.
4O Year	Enter the year of manufacture (or an approximation, if unknown).
4O Market Value	Enter the estimated market value as of the date of this balance sheet.
4P Account Owner	Enter the name of the applicant who owns the account.
4P Type of Account	Enter the account type (IRA, Roth IRA, 401K, etc.)
4P Market Value	Enter the market value of all retirement accounts as of the date of this balance sheet.
4Q Type	Provide a brief description of each real estate parcel owned in each row (house, acreage, commercial lot, etc.).
4Q # Acres	Enter total acres for the parcels listed under Type.
4Q Cost/Acre	Enter the market value per acre for the land listed in Type.
4Q Market Value	Enter the total value of the land by multiplying the number of acres by the value per acre.
5A-5D	LIABILITIES SCHEDULES – FARM
5A Description	Enter the name of the lender, dealer, bank, or individual to whom the accounts are owed.
5A $ Owed	Enter the payment amount due for each account as of the balance sheet date.
5B Creditor	Enter the name of each creditor for notes payable due within 12 months.
5B Purpose	Enter the purpose for each note.
5B Interest Rate	Enter the interest rate for each note.
5B Accrued Interest	Enter the accrued interest for each note as of the balance sheet date.
5B Next Due Date	Enter the next payment due date.
5B # of Pmts/Year	Enter 12 if payments are monthly, 4 if quarterly or 1 if payment is yearly.
5B Payment Amount	Enter the payment amount due for each note.
5B Principal Balance	Enter the unpaid principal balance for each note as of the balance sheet date.
5B TOTALS (Payment Amount)	Enter the total of the "Payment Amount" column from Schedule BB.
5B TOTALS (Principal Balance)	Enter the total of the "Principal Balance" column from Schedule BB.
5C Creditor	Enter each creditor’s name for intermediate liabilities.
5C Purpose	Enter the purpose for each note.
5C Interest Rate	Enter the interest rate for each note.
5C Accrued Interest	Enter the accrued interest for each note as of the balance sheet date.
5C Next Due Date	Enter the next payment due date.
5C # of Pmts/Year	Enter 12 if payments are monthly, 4 if quarterly or 1 if payment is yearly.
5C Payment Amount	Enter the payment amount due for each note.
5C Principal Balance	Enter the unpaid principal balance for each note as of the balance sheet date.
5C TOTALS (Payment Amount)	Enter the total of the "Payment Amount" column from Schedule CC.
5C TOTALS (Principal Balance)	Enter the total of the "Principal Balance" column from Schedule CC.
5D Creditor	Enter each creditor’s name for long-term liabilities.
5D Purpose	Enter the purpose for each note.
5D Interest Rate	Enter the interest rate for each note.
5D Accrued Interest	Enter the accrued interest for each note as of the balance sheet date.
5D Next Due Date	Enter the next payment due date.
5D # of Pmts/Year	Enter 12 if payments are monthly, 4 if quarterly or 1 if payment is yearly.
5D Payment Amount	Enter the payment amount due for each note.
5D Principal Balance	Enter the unpaid principal balance for each note as of the balance sheet date.
5D TOTALS (Payment Amount)	Enter the total of the "Payment Amount" column from Schedule DD.
5D TOTALS (Principal Balance)	Enter the total of the "Principal Balance" column from Schedule DD.
6A-6C	LIABILITIES SCHEDULES – PERSONAL
6A Creditor	Enter each creditor’s name for personal debts.
6A Purpose	Enter the purpose for each personal debt.
6A Interest Rate	Enter the interest rate of each personal debt.
6A Accrued Interest	Enter the accrued interest for each personal debt as of the date of the balance sheet.
6A Next Due Date	Enter the next payment due date.
6A # of Pmts/Year	Enter 12 if payments are monthly, 4 if quarterly or 1 if payment is yearly.
6A Payment Amount	Enter the payment amount due for each note.
6A Principal Balance	Enter the unpaid principal balance for each note as of the balance sheet date.
6A TOTALS (Payment Amount)	Enter the total of the "Payment Amount" column from Schedule EE.
6A TOTALS (Principal Balance)	Enter the total of the "Principal Balance" column from Schedule EE.
6B Creditor	Enter each creditor’s name on each credit card.
6B Monthly Payment Amount	Enter the monthly payment amount due for each credit card.
6B Current Balance	Enter unpaid balance for each credit card as of the date of the balance sheet.
6B Check if PIF w/in 12 mos.	Check the box if the entire balance will be paid in full in less than 12 months.
6B TOTALS (Principal Balance)	Enter the total of the "Current Balance" column from Schedule FF.
6C Creditor	Enter each creditor’s name for term debt.
6C Purpose	Enter the purpose for each note.
6C Interest Rate	Enter the interest rate for each note.
6C Accrued Interest	Enter the accrued interest for each note as of the balance sheet date.
6C Next Due Date	Enter the next payment due date.
6C # of Pmts/Year	Enter 12 if payments are monthly, 4 if quarterly or 1 if payment is yearly.
6C Payment Amount	Enter the payment amount due for each note.
6C Principal Balance	Enter the unpaid principal balance for each note as of the balance sheet date.
6C TOTALS (Payment Amount)	Enter the total of the "Payment Amount" column from Schedule GG.
6C TOTALS (Principal Balance)	Enter the total of the "Principal Balance" column from Schedule GG.

PART I – Cash Flow Projection

Note: This part of the form may be substituted. Applicants may submit alternative documents (which are less than 90 days old) that provide the information collected on this part. CHECK THE BOX in the header at the top of this part if you are submitting an alternative document in lieu of this Part. Applicants using this option will then proceed to Part J.

All other applicants will need to complete this Part in its entirety for all applicable items.

Fld Name / Item No.	Instruction
Production Cycle	Enter the beginning and end dates for the crop year.
1	OPERATING PLAN – PRODUCTION/INCOME
1A Type/Description	Enter a description of each crop that will be produced/sold during the crop cycle i.e.- corn, soybeans, cotton, peanuts, lettuce, etc. Note: List each crop separately. If using different farming practices (for example continuous crop, summer fallow, double crop, pivot irrigated, flood irrigated, etc.) please list each crop separately, as they will have differing yields. Please add additional sheets/paper to account for each type of crops if you need additional space.
1A Unit/Measure	Enter the unit of measure for the crop to be produced i.e., bushels, lbs., bales, etc.
1A Acres	Enter the total acreage to be planted for each crop listed in 1A.
1A Yield	Enter the projected yield per crop for each crop listed in 1A that you can realistically produce. Note: Do not use the average of the combined yields for that crop, because each farm tract will have different yields. Use APH insurance yields. Then use county or state yields, if you have no actual production yields or records from previous owner(s).
1A Farm Use	Enter the quantity or volume of crops held back to be used specifically for the farm and will not be a part of the total projected income calculated from crop sales; for example, enter the volume of hay held back to be used for livestock feed, or grain retained for seed.
1A % Share	If you fully own the crop, enter 100%. Otherwise, enter the shared amount from crop acreages planted that the applicant will receive if leased or shared. Note: Percent share is the allocation/amount of crop share as indicated on the lease or rent contract from a rent/lease agreement with landlords. It is the shared amount from crop acreages planted that the applicant will receive.
1A $/Unit Sales	Enter the price per unit for each crop projected to be sold (or actually sold). Note: Base projections on state/county prices, existing contracts or previous history. This information must be verifiable by FSA.
1A Total $ Sales	Enter the total amount for each crop to be sold (or actually sold). Note: Multiply acres x yield x % share x $/unit (subtract any farm use from yield).
1B Description	Enter a description for each type of livestock or poultry to be raised during the production cycle (for example, broiler chicken, finishing pigs, stocker cattle, catfish fish, meat goats, etc.).
1B # Units Raised	For each type of livestock or poultry listed, enter the number of units you have raised and are planning to sell during the production cycle.
1B Type	Enter the type of livestock you are intending to sell i.e. - calves, fat cattle, fat hogs, weanlings, chicks, kids.
1B Sales Weight of Market Animals	For each type of livestock or poultry listed, enter the projected (or actual) weight to be sold. Note: Changes in operations may impact your projected weight, for example changes in calving or weaning dates.
1B $ per Lb/Unit	For each type of livestock or poultry listed, enter the price per unit projected to be sold (or actually sold). Note: Base projections on state/county prices, existing contracts or previous history. This information must be verifiable by FSA.
1B Total $	For each type of livestock or poultry listed, enter the total dollar amount projected to be sold (or actually sold). Note: To calculate the projected total, multiply units x sales weight x $ per lb.
1C Description	Enter a description for each type of livestock or poultry to be purchased during this production cycle (for example, broiler chicken, finishing pigs, stocker cattle, catfish fish, meat goats, etc.).
1C # Units Purchased	For each type of livestock or poultry listed, enter the number of units you have purchased and are planning to sell during the production cycle.
1C Purchase Weight	Enter the estimated weight of the livestock at the time of purchase.
1C Purchase $	Enter the dollar amount of the livestock to be purchased.
1C Sales Weight of Market Animals	For each type of livestock or poultry listed, enter the projected (or actual) weight to be sold. Note: Changes in operations may impact your projected weight, for example changes in calving or weaning dates.
1C $ Per Lb/Unit	For each type of livestock or poultry listed, enter the price per unit projected to be sold (or actually sold). Note: Base projections on state/county prices, existing contracts or previous history. This information must be verifiable by FSA.
1C Total $	For each type of livestock or poultry listed, enter the total dollar amount projected to be sold (or actually sold). Note: To calculate the projected total, multiply units x sales weight x $ per lb.
1D Description	Enter a description for each type of dairy livestock (for example, sheep, goats, cows, etc.).
1D Breed	Enter the breed of the dairy livestock to be purchased.
1D # Head	Enter the number of head to be purchased or raised.
1D Purch/Raised	For each type of dairy livestock listed, select P for Purchased or R for Raised to designate whether the animals will be purchased (P) or raised (R), that is, animals that are the offspring of existing livestock, raised by the farmer from birth.
1D Purchase Weight	For each type of dairy livestock listed, enter the average weight per unit purchased or raised for sale.
1D Purchase $	For each type of dairy livestock listed, enter the cost per unit purchased or raised for sale. Note: This could be the cost per animal or the cost per pound (live weight) for each type of livestock.
1D Sales Weight	For each type of dairy livestock listed, enter the projected (or actual) weight to be sold. Note: Changes in operations may impact your projected weight, for example changes in calving or weaning dates.
1D $ Per Lb/Unit	For each type of dairy livestock listed, enter the price per unit projected to be sold (or actually sold). Note: Base projections on state/county prices, existing contracts or previous history. This information must be verifiable by FSA.
1D Total $	For each type of livestock or poultry listed, enter the total dollar amount projected to be sold (or actually sold). Note: To calculate the projected total, multiply units x sales weight x $ per lb.
1E Description	Specify the type of milk being produced (for example, dairy cows, sheep, goats).
1E Breed	Enter the breed of the dairy livestock in production.
1E # Head	Enter the number of head of livestock in production.
1E Production/Head	Enter the production per head per year.
1E $ Per Unit	Enter the current market price per unit of measurement (pounds, quarts, gallons, etc.) for the type of milk produced.
1E Total $	Enter the total annual sales of produced milk. Note: Calculate total annual sales by multiplying # head x production/head x $ per Unit.
1F Description	Enter a description of the type of livestock producing the commodity for sale (for example, sheep, goats, poultry, cattle, emu, etc.).
1F Production	For each type of livestock, enter the type of commodity being produced (for example, wool, fur, hide, eggs, meat from broiler chicks, etc.).
1F Measure	For each type of commodity, enter the unit of measure the commodity is to be sold as, such as weight or numbers (lbs. of wool, doz. eggs, lbs. of meat).
1F Units	For each type of commodity, enter the number of units to be sold or actually sold. Note: Consider that some units may be withheld from sale for farm or household use.
1F $/Unit	For each type of commodity, enter the price per unit projected to be sold or (actually sold). Note: Base projections on state/county prices, existing contracts or previous history. This information must be verifiable by FSA.
1F Total $	For each type of commodity, enter the total dollar amount to be sold (or actually sold). Note: Calculate total sales by multiplying units x $/unit.
1G Custom Hire Income Description	Enter a description of all the types of custom work performed for income. Note: This could include machine work, custom cutting, seeding crops, trucking, custom livestock feeding etc. performed on behalf of other operations for hire.
1G Custom Hire Income Total $	Enter the amount of income received (or projected to be received) for custom work done.
1G Other Income Description	Describe any other farm income, such as money from rental properties or the leasing of equipment and livestock.
1G Other Income Amount	Enter the amount of other income received (or projected to be received). Note: This could include co-op dividends, solar energy credits, etc.
1H Personal Income	Enter all income from non-farm sources such as W2 or 1099 income. Note: If calculating gross income, be sure to include payroll deductions in item 2C(1) Total Household Operating expenses
1H Business Income	Enter all income from non-farm business such as seed dealerships, breeding services, landscaping, etc.
1H Other Non-Farm Income	Enter all income from any other non-farm income such as rental properties, etc.
1I Total Income	Enter the total income by combining all the total sales and total income fields from Part 1. Note: Combine all the total fields from items 1A-1H.
2	OPERATING PLAN – EXPENSES
2A Car & Truck	Enter any car and truck expenses that you are projecting for the operating cycle. Note: This does not include loan payments but does include repair and maintenance to farm vehicles. See your tax return for reference.
2A Chemicals	Enter any expenses for chemicals that you are projecting for the operating cycle. Note: This could include summer fallow treatments, pre-plant spray, in-crop spray, seed treat, and organic compounds used for weed control.
2A Conservation	Enter any expenses related to conservation that you are projecting for the operating cycle. Note: Consider any NRCS contract obligations that may require upfront cost, for example the cost of seeding a pollinator habitat or special fencing.
2A Custom Hire	Enter expenses related to custom hires that you are projecting for the operating cycle. Note: This may include custom seeding, harvesting, trucking, and manure spreading that you are paying others to perform on your behalf.
2A Feed Supplements	Enter any expenses for feed supplements that you are projecting for the operating cycle. Note: This may include salt and minerals.
2A Feed, Grain & Roughage	Enter any feed, grain, and/or roughage expenses that you are projecting for the operating cycle. Note: This may include straw for bedding and specialized feed for livestock development.
2A Fertilizers & Lime	Enter any expenses for fertilizer and lime that you are projecting for the operating cycle. Note: This may include organic fertilizers, for example fish oil compounds.
2A Freight & Trucking	Enter any freight and/or trucking expenses that you are projecting for the operating cycle. Note: This includes the cost of transporting seed and feed to your farm and transporting product to market.
2A Gas/Fuel/Oil	Enter any gas, fuel, and/or oil expenses that you are projecting for the operating cycle.
2A Insurance	Enter any insurance-related expenses that you are projecting for the operating cycle. Note: Include crop insurance, hail insurance, farm liability, workman's comp, etc. Do NOT include personal health and life insurance.
2A Labor Hired	Enter any expenses for hired labor that you are projecting for the operating cycle.
2A Rent – Machinery/Equipment/Vehicles	Enter amount calculated in 2B(1) for scheduled rent- machine/equip/vehicle.
2A Rent – Land/Animals	Enter the amount calculated in 2B(2).
2A Repairs & Maintenance	Enter expenses for repairs and maintenance that you are projecting for the operating cycle. Note: Consider any major repairs you may have for the year.
2A Seeds & Plants	Enter any expenses for seeds, plants, or both that you are projecting for the operating cycle.
2A Storage & Warehousing	Enter any expenses for storage and warehousing that you are projecting for the operating cycle.
2A Supplies	Enter any expenses related to supplies that you are projecting for the operating cycle.
2A Taxes – Real Estate	Enter any expenses related to real estate taxes that you are projecting for the operating cycle.
2A Utilities	Enter any expenses for utilities that you are projecting for the operating cycle.
2A Veterinary/Breeding/Medicine	Enter any expenses for veterinary care, breeding, and/or medicine that you are projecting for the operating cycle.
2A Other Expenses	Enter any other expenses that you are projecting for the operating cycle.
2A Other – Irrigation Expenses	Enter any expenses related to irrigation that you are projecting for the operating cycle.
2B(1) Rent – Machine/Equip/Vehicle	Owner/Dealer - List the name of the owner or dealership the item is being rented from. Description - Enter a description of the item being rented i.e. tractor, loader, baler, seeder. # Units - Enter the number of units (hours) being rented. $ Amount Paid - Enter the total cost of the item to be rented.
2B(2) Rent – Land/Animals	Owner - List the Owner of the land/animal being rented. County/State - List the county and state where the land/animal is located. Section/Twp - List the section and township where the land/animal is located. Farm # - List the FSA farm number. Total Acres - List the total number of acres listed by the rental agreement. Crop Acres - List the total number of crop acres listed in the rental agreement (may be the same as total acres depending on the lease). % Share - List the precent share on the lease Amount/Acre - List the total dollar amount paid per acre according to the lease agreement Total $ Paid - List the total dollar amount paid to the Owner of the land/animal.
2B(2) Total	Enter the total amount of land rent calculated from 2B(2). Transfer number to section in 2A.
2C(1) Total Household Operating Expenses	Include all household operating expenses such as groceries, utilities, health insurance, and income taxes for the whole production cycle.
2C(2) Capital Purchases	Type of capital purchase - list any machinery, equipment, breeding stock, real estate purchases planned during the operating year. $ Amount - List anticipated cost of the item to be purchased.
2D Total Expenses	Enter all expenses calculated from 2A and 2C.
3 Net Income/Loss (PRIOR to debt repayment)	Calculate net income/loss by utilizing the income in 1I (Total Income) minus 2D (Total Expenses).

PART J – Notifications, Disclosures & Acknowledgement

Items 1 – 9 are applicable to ALL applicants.

Fld Name / Item No.	Instruction
1-9 Notifications, Disclosures & Acknowledgement	Read all statements (1 through 9) on pages 9 & 10.
9A Signature	Enter the primary applicant's signature.
9B Printed Name	Enter the printed name of the primary applicant.
9C Date	Enter the date the primary applicant signs the application.
9D Capacity	Enter a check in the box to indicate in what position the applicant is signing. Entity members will select "self" when signing as individuals. Only the Authorized Entity Representative listed in official corporate, or entity documents will check the box marked "Entity Representative". The Authorized Entity Representative also must sign as "self".
9E Signature	Enter the additional member signature identified on page 2 of this application, if any.
9F Printed Name	Enter the printed name of this additional member, if any.
9G Date	Enter the date this additional member signs the application, if applicable.
9H Capacity	Enter a check in the box to indicate in what position the applicant is signing. Entity members will select "self" when signing as individuals. Only the Authorized Entity Representative listed in official corporate, or entity documents will check the box marked "Entity Representative". The Authorized Entity Representative also must sign as "self", (if applicable).
9I Signature	Enter the 2nd additional member signature identified on page 2 of this application, if any.
9J Printed Name	Enter the printed name of this additional member, if any.
9K Date	Enter the date this additional member signs the application, if applicable.
9L Capacity	Enter a check in the box to indicate in what position the applicant is signing. Entity members will select "self" when signing as individuals. Only the Authorized Entity Representative listed in official corporate, or entity documents will check the box marked "Entity Representative". The Authorized Entity Representative also must sign as "self", (if applicable).

PART K – FSA Use Only

Items 1 – 7 are completed by an FSA official. Applicants, DO NOT complete this Part.

PART L – Supporting Information

Items listed in upper portion of the table are required for a complete application and are applicable to ALL applicants. The lower portion, identified as “Entities Only,” are applicable to Entity Applicants only. NOTE: This is NOT an all-inclusive list and additional items may be needed for a complete application on a case-by-case basis. An FSA official will contact you for additional items needed, if any, after reviewing your application.

Fld Name / Item No.	Instruction
Submission Requirements	Attach the appropriate items as indicated for the type of assistance the applicant is requesting. REMINDER: If the applicant selected the box indicating they were supplying an alternative document in Parts H (Balance Sheet) or Part I (Cash Flow Projection), those must also be provided.

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